Clinica Terapeutica最新文献

{"title":"Burnout between personality traits and bowel disorders. An exploratory study of a sample of nurses students.","authors":"P Ricci, G E Cafiero, E Greco, A Vinci, F Damato, R Ferrara","doi":"10.7417/CT.2025.5249","DOIUrl":"10.7417/CT.2025.5249","url":null,"abstract":"<p><strong>Background: </strong>Burnout is a complex psychosocial syndrome characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment, with significant implications for both mental and physical health. Nursing students appear particularly vulnerable to burnout, which can be associated with somatic symptoms, including gastrointestinal disturbances. Despite existing evidence suggesting correlations between burnout and physical disorders, the interplay between burnout, personality traits, and somatization remains underexplored.</p><p><strong>Objective: </strong>This study aimed to investigate the relationship between burnout levels, personality traits, and self-reported bowel disorders among nursing students. A secondary objective was to quantify the psychological components associated with these symptoms.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 196 nursing students from Sapienza University of Rome. Participants completed the Maslach Burnout Inventory (MBI), the Personality Assessment Inventory (PAI), and a health status questionnaire. Descriptive statistics, Spearman's correlation with bootstrapping, and multivariable ordinal logistic regression analyses were performed to explore associations between burnout dimensions, personality traits, and somatic symptoms, particularly bowel dysfunction.</p><p><strong>Results: </strong>Burnout components, especially emotional exhaustion and depersonalization, were significantly associated with somatic complaints and self-reported bowel disorders. Female students and those living with others reported higher frequencies of bowel-related symptoms. High PAI somatization and conversion scores were observed among participants with frequent pain and defecation difficulties. Physical activity and adequate sleep appeared as protective factors, while poor sleep quality was associated with higher emotional exhaustion and depersonalization scores.</p><p><strong>Conclusions: </strong>The study highlights the early onset of burnout symptoms among nursing students and their potential somatic correlates, particularly gastrointestinal symptoms. These findings underscore the need for integrated intervention strategies that address both psychological and physical health dimensions in nursing students, with particular attention to lifestyle factors such as sleep and physical activity.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 4","pages":"459-467"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medico legal study on the correct management of the medical clinic in the military field.","authors":"M Salducci, R Raimondi, M S Simonelli","doi":"10.7417/CT.2025.5256","DOIUrl":"10.7417/CT.2025.5256","url":null,"abstract":"<p><strong>Abstract: </strong>This study aims to analyze the best practices and standardized procedures for the management of these resources, examining the ethical, legal and organizational implications. Finally, a scheme for the correct management of a medical clinic is proposed.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 4","pages":"512-514"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reflective learning and reflective practice: foundational education theories and applications in surgery.","authors":"F P Prete, M Covelli, A Ballini, M A A Karaboue, A Gurrado, A De Luca, G M De Luca, M Testini","doi":"10.7417/CT.2025.5258","DOIUrl":"10.7417/CT.2025.5258","url":null,"abstract":"<p><strong>Abstract: </strong>Reflection, as an essential component of reflective learning and reflective practice, is regarded as a valuable tool in various medical settings. It is crucial for surgeons, both in the context of training and specialist practice, to ponder on their experiences, exploring with rigour the complexities of their actions, assess their performance, and identify areas for improvement. These features make reflection also important for life-long learning and maintenance of certification to assure competency. Practitioners often need appropriate education on reflection; however, reflection is still understudied and underutilized in surgery, and implementation of reflection as a learning strategy is still limited.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 4","pages":"520-527"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial Insights into Targeted Axillary Dissection Post-Neoadjuvant Therapy in Node-Positive Breast Cancer: A Pilot Interventional Study.","authors":"A Aosmali, M Nafie, A Nafie, R Radwan, B Soliman, M Alkhalaf","doi":"10.7417/CT.2025.5252","DOIUrl":"10.7417/CT.2025.5252","url":null,"abstract":"<p><strong>Background: </strong>The most commonly detected malignancy and the second most prevalent cause of cancer-related death in women globally is breast cancer. The treatment of breast cancer is significantly influen-ced by the accurate staging and proper management of axillary lymph nodes (ALNs). The surgical management of the axilla in breast cancer has undergone a significant transformation over the past two decades. The routine axillary lymph nodes (LN) dissection, which is associated with a higher level of morbidity in early-stage node-negative patients, has been replaced by sentinel LN biopsy (SLNB), which was initially investigated in the early nineties. SLNB offers precise evaluations of nodal status and essential staging data.</p><p><strong>Objective: </strong>To determine the accuracy of targeted axillary resection and ensuring surgical removal of clipped nodes would improve accuracy of nodal staging in those patients.</p><p><strong>Patients and methods: </strong>This Pilot Interventional study was conducted at Al Demerdash Hospital, Faculty of Medicine, Ain Shams University, between March 2020 and March 2021. The institutional research and ethics committee reviewed and approved the study protocol. Thirty patients with clinical node-positive breast cancer who were undergoing neo-adjuvant chemotherapy (NACT) were involved in the study.</p><p><strong>Results: </strong>In all, 24 patients with clipped ALNs were stained with patent blue dye and five patients with clipped ALNs were not stained by patent blue dye. Therefore, SLNB was unable to detect five clipped ALNs in five patients, so there is a false-negative rate (FNR) of 17.2%. Therefore, with the targeted procedure we can decrease the FNR of sentinel nodes.</p><p><strong>Conclusion: </strong>Targeted axillary dissection is a feasible technique for axillary management in clinically N1 breast cancer patients who receive NACT and turned to N0. Preoperative clipped node guide wire localization significantly enhances the identification clipped node rate and decreases the FNR of SLNB alone.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 4","pages":"487-494"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Criminalization of Surrogacy in Italy: Legal Framework, Ethical Tensions, and European Perspectives.","authors":"V Piersanti, D Marchesini, E Pelagatti, A C Caruso, F Sciuttini, M La Greca","doi":"10.7417/CT.2025.5257","DOIUrl":"10.7417/CT.2025.5257","url":null,"abstract":"<p><strong>Objectives: </strong>Surrogacy remains one of the most contentious topics in contemporary reproductive law, sparking intense debate across legal, ethical, and social spheres. In Italy, the recent introduction of universal criminal jurisdiction has considerably tightened the regulatory framework, extending criminal liability to acts committed abroad by Italian citizens. This legislative development raises significant concerns, particularly in relation to the principles of legality, proportionality, and harm, as well as its implications for safeguarding the best interests of the child. This article explores the risks posed by a strictly punitive approach, contrasting the Italian model with those adopted in other European jurisdictions. Particular attention is paid to the rights of surrogate mothers, the legal recognition of family relationships, the child's right to know their origins, and the legal status of the embryo. The analysis highlights how the absence of a balanced regulatory framework can increase vulnerability and legal uncertainty for all parties involved.</p><p><strong>Materials and methods: </strong>This study draws upon jurisprudence from the Italian Constitutional Court, the Court of Cassation, and the European Court of Human Rights, as well as legislative developments and practices in various European legal systems. A systematic literature review was conducted using the Italian legal database De Jure and the international database Scopus. Keywords included: surrogacy, universal criminal jurisdiction, best interests of the child, intentional parenthood, Italian Constitutional Court, and assisted reproductive technologies (ART). Duplicate records were excluded, and all relevant sources were thoroughly reviewed. The research scope was further expanded by incorporating cited references from primary literature.</p><p><strong>Results: </strong>The extraterritorial application of criminal sanctions raises several critical issues: it challenges the principle of legality, diverges from prevailing European legal standards, and complicates the recognition of family ties in cases involving children born through surrogacy. Moreover, this punitive framework risks obscuring the altruistic and therapeutic dimensions associated with ART. When properly regulated, altruistic and informed surrogacy may offer an ethically acceptable solution for individuals facing profound reproductive challenges.</p><p><strong>Conclusions: </strong>This article argues for moving beyond a predominantly punitive stance on surrogacy. It advocates for a regulatory framework that clearly distinguishes between commercial and altruistic surrogacy, protects the rights of surrogate mothers, ensures transparency and informed consent, and guarantees full legal and emotional recognition of children. Only a rights-based, inclusive approach can adequately address the multifaceted nature of the surrogacy phenomenon.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 4","pages":"515-519"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Harnessing Imaging Across Medical Specialties: Present Value and Future Radiomic Horizons","authors":"P Frisina","doi":"10.7417/CT.2025.5243","DOIUrl":"10.7417/CT.2025.5243","url":null,"abstract":"<p><strong>Abstract: </strong>Diagnostic imaging plays a pivotal role across all medical disciplines, serving as the cornerstone for decision-making in both acute and chronic care. This article explores emerging evidence from diverse specialties-ranging from ophthalmology and hepatology to neurology and respiratory medicine-highlighting the indispensable role of imaging in guiding pharmacological, surgical, and rehabilitative strategies. More importantly, it emphasizes the transformative potential of radiomics, a data-driven approach that extracts high-dimensional quantitative features from routine CT, MRI, PET, and ultrasound scans. Unlike traditional qualitative interpretation, radiomics enables the development of predictive models that integrate imaging biomarkers with clinical, molecular, and genomic data. Case examples illustrate how radiomic analysis can improve disease stratification, guide perso-nalized therapies, and accelerate clinical trials. By leveraging existing picture-archiving systems without requiring additional procedures or contrast agents, radiomics offers a non-invasive \"virtual biopsy\" that expands the informational yield of every scan. This paradigm shift toward image-based precision medicine will require interdisciplinary collaboration between radiologists, clinicians, and data scientists but holds the promise of more accurate, efficient, and individualized care. The convergence of radiomic analytics and multidisciplinary practice heralds a new era in which imaging becomes not just a diagnostic tool, but a rich and reusable data asset that shapes therapeutic decisions and health outcomes.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 4","pages":"416-417"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LC-MS Analysis of Bioactive Compounds in Cynodon dactylon: A Step Towards Therapeutic drug development.","authors":"M Gokul, A K Nayanatara, R D Kini, R Sheryl","doi":"10.7417/CT.2025.5242","DOIUrl":"10.7417/CT.2025.5242","url":null,"abstract":"<p><strong>Purpose: </strong>Phytochemicals are naturally occurring bioactive compounds produced by plants as a defense against environmental stressors. Cynodon dactylon is a widely distributed medicinal plant known for its diverse pharmacological properties. The present study explores the bioactive compounds of the hydro-alcoholic extract of Cynodon dactylon.</p><p><strong>Methods: </strong>The entire Cynodon dactylon plant was collected, authenticated, and extracted using a Soxhlet apparatus with a hydro-alcoholic solvent. Phytochemical analysis was conducted using Thin Layer Chromatography (TLC) and Liquid Chromatography-Mass Spectrometry (LC-MS) was done to identify specific bioactive compounds.</p><p><strong>Results: </strong>TLC analysis confirmed the presence of potent phyto-chemicals. LC-MS analysis revealed multiple bioactive compounds, including Harmine, which was identified for the first time in Cynodon dactylon.</p><p><strong>Conclusion: </strong>The identification of multiple bioactive compounds in Cynodon dactylon, particularly Harmine, highlights its potential for neuroprotection and the treatment of neuropsychiatric disorders. Further in vivo and clinical studies are needed to validate these findings and explore the plant's therapeutic applications in neurological health.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 4","pages":"408-415"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-Clostridium difficile Bacterial Infection in an Acute Flare of Crohn's Disease: A Case Report and Literature Review.","authors":"N T Phan, P T Ho, N P Ma, T T Nguyen, T M Huynh","doi":"10.7417/CT.2025.5240","DOIUrl":"10.7417/CT.2025.5240","url":null,"abstract":"<p><strong>Abstract: </strong>Crohn's disease is a chronic inflammatory condition affecting any part of the gastrointestinal tract. Acute exacerbations pose a diagnostic challenge due to the difficulty in distinguishing active Crohn's disease from other causes, particularly infections. While Clostridium difficile infection is well-documented and typically screened for in symptomatic Crohn's patients, other enteric infections are often under-recognized and lack sufficient evidence. We report the case of a 17-year-old male with known colonic Crohn's disease who presented with a five-day history of fever and diarrhea. Initial treatment with ciprofloxacin was ineffective, suggesting a quinolone-resistant pathogen. Traditional diagnostic approaches, including stool cultures, failed to identify the pathogen. However, subsequent multiplex polymerase chain reaction testing of stool samples identified Campylobacter species, and signi-ficant clinical improvement was observed following azithromycin therapy. This case underscores the importance of considering non-Clostridium difficile infections in the differential diagnosis of Crohn's disease flares and highlights the clinical utility of multiplex polymerase chain reaction in rapidly identifying resistant pathogens. Implementing such molecular diagnostics is crucial for improving patient outcomes.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 4","pages":"394-398"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"XIV National Congress of the Research Group in Psychosomatics (RGP).","authors":"A A Vv","doi":"10.7417/CT.2025.5217","DOIUrl":"https://doi.org/10.7417/CT.2025.5217","url":null,"abstract":"<p><strong>Foreword: </strong>In recent years, growing scientific attention has been directed toward understanding how the environment shapes health outcomes, not only from a biomedical perspective but also in light of psychosocial dimensions. This special issue gathers the abstracts from the XIV Congresso Nazionale del Gruppo di Ricerca in Psicosomatica, that took place on the 19-20th of June 2025 at the University of Verona, entitled: \"The individual and their environment within the integrated psychosomatic approach\". The event was conceived as a platform for interdisciplinary dialogue and brought together clinicians, researchers, and scholars from diverse disciplines to reflect on the profound and complex influence that environmental factors exert on individual well-being. This special issue includes the abstracts from a wide range of contributions, encompassing 3 pre-congress workshops, 13 symposia, and 6 thematic sessions, for a total of 79 oral presentations, 22 posters, and 3 clinical case discussions. Also included are the abstracts of the two keynote lectures, titled: \"The future of psychosomatic medicine\" and \"Navigating Ethical and Clinical Challenges in Global Surgery: Reflections from the Field\". All abstracts highlighted how biopsychosocial variables may contribute in shaping health and illness trajectories, particularly when facing chronicity or disability, psychosomatic conditions, mental health or social vulnerabilities, and public health challenges. Through multiple sessions, experts addressed key topics such as the positive impact of nature-based interventions, the role of bodily self-awareness and somatic correlates in conditions like fibromyalgia, and the affective dimensions of alexithymia, for example in functional disorders. Other contributions explored the interplay between early trauma, epigenetic mechanisms, and psychosomatic adaptation. Ethical and psychological challenges of organ transplan-tation or taking care of people living with oncological conditions or at high risk have been also proposed. Presentations further focused on integrated care models in different settings, proposing hospitals as an environment for mental health promotion for patients, professionals, and the broader community. This special issue not only serves as a record of the multifaced scientific contributions presented during the conference but also as stimulus for the adoption of integrative approaches to healthcare. It reaffirms the importance of a biopsychosocial model that respects the complexity of human experience, including also the environment in all its dimensions. We hope that these abstracts will inspire further research, collaborative practice, and innovative interventions that honor the full spectrum of factors influencing health, ultimately advancing a more sustainable, inclusive, and compassionate vision of care.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 Suppl 1(3)","pages":"1-118"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sudden Death Due To Excited Delirium Syndrome: From Pathophysiology To Postmortem Assessment: Case Reports.","authors":"C Mondello, V Cianci, E Denaro, A Cianci, D Speranza, F Omero, L Pepe, V Fiorentino, C Pizzimenti, P Gualniera, A Asmundo, D Sapienza","doi":"10.7417/CT.2025.5218","DOIUrl":"10.7417/CT.2025.5218","url":null,"abstract":"<p><strong>Abstract: </strong>Excited Delirium Syndrome is a rare disease which can be re-sponsible for sudden/unexpected death. ExDS-related death frequently occur during or immediately after a physical effort, typically a scuffle with law enforcement workers. Its incidence is underestimated, and the pathophysiological mechanism is yet unclear. It is suggested the occurrence of factors acting as trigger of the syndrome such as abuse substance (i.e. cocaine) assumption and psychiatric illness. Moreover, other conditions that can determine the sudden death are hyperthermia and lactic acidosis. Here, two forensic cases of ExDS involving male subjects, respectively of 42 and 34 years, were described. In the first case the use of drugs was documented, in the second one a psychiatric illness was diagnosed. In both cases, after scuffling with police, the men suddenly died. The cases have been discussed on the basis of the main literature evidence on the disease pathophysiology, \"clinical\" manifestation, trigger factors and post-mortem findings. The reported cases and the evidence of the literature highlighted that ExDS forensic analyses requires applying multiple diagnostic investigations aimed at ascertaining both the presence of trigger factors and the cardiac catecholaminergic hyperstimulation. Thus, the forensic pathologist can improve the knowledge on this disease, helping the law enforcement office and healthcare practitioners to prevent and manage these medical emergencies.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"176 3","pages":"255-260"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}